Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort study

BackgroundThis research investigates the relationships between the composite dietary antioxidant index (CDAI) and the likelihood of cardiovascular disease (CVD) and mortality in older adults with hypertension. Utilized data from the National Health and Nutrition Examination Survey (NHANES) to invest...

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Main Authors: Yajie Zhang, Yingying Liu, Huiquan Qiao, Qiongqiong Ma, Bing Zhao, Qian Wu, Hongyu Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1574876/full
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author Yajie Zhang
Yingying Liu
Huiquan Qiao
Qiongqiong Ma
Bing Zhao
Qian Wu
Hongyu Li
author_facet Yajie Zhang
Yingying Liu
Huiquan Qiao
Qiongqiong Ma
Bing Zhao
Qian Wu
Hongyu Li
author_sort Yajie Zhang
collection DOAJ
description BackgroundThis research investigates the relationships between the composite dietary antioxidant index (CDAI) and the likelihood of cardiovascular disease (CVD) and mortality in older adults with hypertension. Utilized data from the National Health and Nutrition Examination Survey (NHANES) to investigate the potential mediating role of the triglyceride-glucose (TyG) index in these relationships.MethodsA cohort of 5,276 participants, aged 65 years or older and diagnosed with hypertension, was extracted from the NHANES database. The main outcomes examined were the odds of CVD and mortality, utilizing data from the National Center for Health Statistics (NCHS). Multivariate logistic regression models were utilized to evaluate the relationship between CDAI and CVD. Cox proportional hazards regression models and Kaplan–Meier survival curves were utilized to analyze the relationship between CDAI and mortality. Mediation analysis was conducted to assess the potential intermediary role of TyG-related indicators—specifically TyG, TyG-BMI, TyG-WC, and TyG-WHtR— in the connection between CDAI and mortality.ResultsThe mean CDAI for the study participants was 1.88 ± 3.90, and the average age was 74.15 ± 5.96 years. During an average follow-up duration of 109.51 months, 4,712 cases of CVD and 725 recorded deaths were observed. In the fully adjusted models, CDAI showed a negative association with both CVD (Odds Ratio [OR] = 0.94, 95% Confidence Interval [CI] = 0.92–0.97) and mortality (Hazard Ratio [HR] = 0.95, 95% CI = 0.93–0.97). Mediation analysis indicated that the TyG-BMI, TyG-WC, and TyG-WHtR indices accounted for 33.1%, 34.3%, and 19.1% of the relationship between CDAI and mortality, respectively.ConclusionA higher CDAI demonstrated an inverse association with both CVD and mortality in elderly hypertensive individuals. The relationship was partially mediated by TyG-related indices, indicating that increased antioxidant intake may lead to improved health outcomes and a decreased risk of poor prognosis in this population.
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spelling doaj-art-facb6f2dca694f4ba5143d08a4c262b32025-08-20T02:25:02ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-04-011210.3389/fnut.2025.15748761574876Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort studyYajie Zhang0Yingying Liu1Huiquan Qiao2Qiongqiong Ma3Bing Zhao4Qian Wu5Hongyu Li6Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Biomedical Sciences, Institute for Medical Science, Jeonbuk National University Medical School, Jeonju, Republic of KoreaDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaBackgroundThis research investigates the relationships between the composite dietary antioxidant index (CDAI) and the likelihood of cardiovascular disease (CVD) and mortality in older adults with hypertension. Utilized data from the National Health and Nutrition Examination Survey (NHANES) to investigate the potential mediating role of the triglyceride-glucose (TyG) index in these relationships.MethodsA cohort of 5,276 participants, aged 65 years or older and diagnosed with hypertension, was extracted from the NHANES database. The main outcomes examined were the odds of CVD and mortality, utilizing data from the National Center for Health Statistics (NCHS). Multivariate logistic regression models were utilized to evaluate the relationship between CDAI and CVD. Cox proportional hazards regression models and Kaplan–Meier survival curves were utilized to analyze the relationship between CDAI and mortality. Mediation analysis was conducted to assess the potential intermediary role of TyG-related indicators—specifically TyG, TyG-BMI, TyG-WC, and TyG-WHtR— in the connection between CDAI and mortality.ResultsThe mean CDAI for the study participants was 1.88 ± 3.90, and the average age was 74.15 ± 5.96 years. During an average follow-up duration of 109.51 months, 4,712 cases of CVD and 725 recorded deaths were observed. In the fully adjusted models, CDAI showed a negative association with both CVD (Odds Ratio [OR] = 0.94, 95% Confidence Interval [CI] = 0.92–0.97) and mortality (Hazard Ratio [HR] = 0.95, 95% CI = 0.93–0.97). Mediation analysis indicated that the TyG-BMI, TyG-WC, and TyG-WHtR indices accounted for 33.1%, 34.3%, and 19.1% of the relationship between CDAI and mortality, respectively.ConclusionA higher CDAI demonstrated an inverse association with both CVD and mortality in elderly hypertensive individuals. The relationship was partially mediated by TyG-related indices, indicating that increased antioxidant intake may lead to improved health outcomes and a decreased risk of poor prognosis in this population.https://www.frontiersin.org/articles/10.3389/fnut.2025.1574876/fullcomposite dietary antioxidant indexcardiovascular diseasetriglyceride glucose-related indexmortalitynational health and nutritionhypertension
spellingShingle Yajie Zhang
Yingying Liu
Huiquan Qiao
Qiongqiong Ma
Bing Zhao
Qian Wu
Hongyu Li
Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort study
Frontiers in Nutrition
composite dietary antioxidant index
cardiovascular disease
triglyceride glucose-related index
mortality
national health and nutrition
hypertension
title Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort study
title_full Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort study
title_fullStr Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort study
title_full_unstemmed Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort study
title_short Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort study
title_sort mediating role of triglyceride glucose related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension a national cohort study
topic composite dietary antioxidant index
cardiovascular disease
triglyceride glucose-related index
mortality
national health and nutrition
hypertension
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1574876/full
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